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Article ; Online: Mapping brain volume change across time in primary-progressive multiple sclerosis.

Warszawer, Yehuda / Gurevich, Michael / Kerpel, Ariel / Dreyer Alster, Sapir / Nissan, Yael / Shirbint, Emanuel / Hoffmann, Chen / Achiron, Anat

Neuroradiology

2024

Abstract: Purpose: Detection and prediction of the rate of brain volume loss with age is a significant unmet need in patients with primary progressive multiple sclerosis (PPMS). In this study we construct detailed brain volume maps for PPMS patients. These maps ... ...

Abstract	Purpose: Detection and prediction of the rate of brain volume loss with age is a significant unmet need in patients with primary progressive multiple sclerosis (PPMS). In this study we construct detailed brain volume maps for PPMS patients. These maps compare age-related changes in both cortical and sub-cortical regions with those in healthy individuals. Methods: We conducted retrospective analyses of brain volume using T1-weighted Magnetic Resonance Imaging (MRI) scans of a large cohort of PPMS patients and healthy subjects. The volume of brain parenchyma (BP), cortex, white matter (WM), deep gray matter, thalamus, and cerebellum were measured using the robust SynthSeg segmentation tool. Age- and gender-related regression curves were constructed based on data from healthy subjects, with the 95% prediction interval adopted as the normality threshold for each brain region. Results: We analyzed 495 MRI scans from 169 PPMS patients, aged 20-79 years, alongside 563 exams from healthy subjects aged 20-86. Compared to healthy subjects, a higher proportion of PPMS patients showed lower than expected brain volumes in all regions except the cerebellum. The most affected areas were BP, WM, and thalamus. Lower brain volumes correlated with longer disease duration for BP and WM, and higher disability for BP, WM, cortex, and thalamus. Conclusions: Constructing age- and gender-related brain volume maps enabled identifying PPMS patients at a higher risk of brain volume loss. Monitoring these high-risk patients may lead to better treatment decisions and improve patient outcomes.
Language	English
Publishing date	2024-04-13
Publishing country	Germany
Document type	Journal Article
ZDB-ID	123305-1
ISSN	1432-1920 ; 0028-3940
ISSN (online)	1432-1920
ISSN	0028-3940
DOI	10.1007/s00234-024-03354-7
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Zs.A 658: Show issues

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Article: Imaging Findings in Four COVID-19 Patients.

Kerpel, Ariel / Nissan, Noam / Klug, Maximiliano / Amit, Sharon / Konen, Eli / Marom, Edith M

The Israel Medical Association journal : IMAJ

2020 Volume 22, Issue 4, Page(s) 214–215

MeSH term(s)	Betacoronavirus ; COVID-19 ; COVID-19 Testing ; Clinical Laboratory Techniques ; Coronavirus ; Coronavirus Infections/diagnosis ; Coronavirus Infections/diagnostic imaging ; Humans ; Lung/diagnostic imaging ; Male ; Middle Aged ; Pandemics ; Pneumonia, Viral/diagnosis ; Pneumonia, Viral/diagnostic imaging ; SARS-CoV-2 ; Tomography, X-Ray Computed
Keywords	covid19
Language	English
Publishing date	2020-04-26
Publishing country	Israel
Document type	Case Reports ; Journal Article
ZDB-ID	2008291-5
ISSN	1565-1088 ; 0021-2180
ISSN	1565-1088 ; 0021-2180
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Zs.A 5470: Show issues

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Article ; Online: Magnetic Resonance Imaging for the Follow-up of Treated Thymic Epithelial Malignancies.

Kerpel, Ariel / Beytelman, Arkadi / Ofek, Efrat / Marom, Edith M

Journal of thoracic imaging

2019 Volume 34, Issue 6, Page(s) 345–350

Abstract: Purpose: The purpose of this article was to compare magnetic resonance imaging (MRI) depiction of thymic malignancy progression/recurrence with that of computed tomography (CT).: Methods: We retrospectively reviewed all surgically treated thymic ... ...

Abstract	Purpose: The purpose of this article was to compare magnetic resonance imaging (MRI) depiction of thymic malignancy progression/recurrence with that of computed tomography (CT). Methods: We retrospectively reviewed all surgically treated thymic epithelial malignancy (TEM) patients between 2011 and 2018 who were followed-up with chest CT and MRI. We compared the detection of recurrence and metastatic disease between the CT and MRI scans in each of these patients. Results: Of 187 patients treated in our institution for TEM, 22 were followed-up with both CT and MRI. TNM stage at diagnosis was as follows: I (n=14), II (n=1), IIIa (n=4), IIIb (n=2), IVa (n=1), and IVb (n=0). Patients were followed-up for a mean of 6.2 years, range 0.7 to 17.7 years. The mean interval between CT and MRI was 5.4 (range, 1 to 15) months. Most patients had no recurrence (n=16), 4 had recurrence after R0 or R1 resection, 1 had stable disease, and 1 had progression of disease after R2 resection. CT and MRI performed equally in the identification of pleural spread (n=5), lymphadenopathy (n=4), and pulmonary metastases (n=1). Retrosternal recurrence (n=1) was identified by MRI despite sternotomy wire artifacts. MRI identified bone involvement and extension of disease into the thecal sac earlier and more readily. Three patients had an indeterminate mediastinal finding on CT that was correctly identified as a benign cyst or pericardial fluid collection by MRI. Conclusion: MRI is an alternative option to follow-up patients after treatment for TEM. However, for those with metallic sternotomy wires, we recommend alternating the follow-up with CT as well.
MeSH term(s)	Adult ; Aged ; Artifacts ; Contrast Media ; Disease Progression ; Female ; Follow-Up Studies ; Foreign Bodies/diagnostic imaging ; Humans ; Iohexol ; Magnetic Resonance Imaging/methods ; Male ; Meglumine ; Middle Aged ; Neoplasm Recurrence, Local/diagnostic imaging ; Neoplasms, Glandular and Epithelial/diagnostic imaging ; Neoplasms, Glandular and Epithelial/surgery ; Organometallic Compounds ; Retrospective Studies ; Sternotomy ; Thymus Neoplasms/diagnostic imaging ; Thymus Neoplasms/surgery ; Tomography, X-Ray Computed/methods
Chemical Substances	Contrast Media ; Organometallic Compounds ; Iohexol (4419T9MX03) ; Meglumine (6HG8UB2MUY) ; gadoterate meglumine (L0ND3981AG)
Language	English
Publishing date	2019-08-29
Publishing country	United States
Document type	Comparative Study ; Journal Article
ZDB-ID	632900-7
ISSN	1536-0237 ; 0883-5993
ISSN (online)	1536-0237
ISSN	0883-5993
DOI	10.1097/RTI.0000000000000444
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Zs.A 2187: Show issues

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Article: Ultra-Low Dose Chest CT with Denoising for Lung Nodule Detection.

Kerpel, Ariel / Marom, Edith Michelle / Green, Michael / Eifer, Michal / Konen, Eli / Mayer, Arnaldo / Betancourt Cuellar, Sonia L

The Israel Medical Association journal : IMAJ

2021 Volume 23, Issue 9, Page(s) 550–555

Abstract: Background: Medical imaging and the resultant ionizing radiation exposure is a public concern due to the possible risk of cancer induction.: Objectives: To assess the accuracy of ultra-low-dose (ULD) chest computed tomography (CT) with denoising ... ...

Abstract	Background: Medical imaging and the resultant ionizing radiation exposure is a public concern due to the possible risk of cancer induction. Objectives: To assess the accuracy of ultra-low-dose (ULD) chest computed tomography (CT) with denoising versus normal dose (ND) chest CT using the Lung CT Screening Reporting and Data System (Lung-RADS). Methods: This prospective single-arm study comprised 52 patients who underwent both ND and ULD scans. Subsequently AI-based denoising methods were applied to produce a denoised ULD scan. Two chest radiologists independently and blindly assessed all scans. Each scan was assigned a Lung-RADS score and grouped as 1 + 2 and 3 + 4. Results: The study included 30 men (58%) and 22 women (42%); mean age 69.9 ± 9 years (range 54-88). ULD scan radiation exposure was comparable on average to 3.6-4.8% of the radiation depending on patient BMI. Denoising increased signal-to-noise ratio by 27.7%. We found substantial inter-observer agreement in all scans for Lung-RADS grouping. Denoised scans performed better than ULD scans when negative likelihood ratio (LR-) was calculated (0.04--0.08 vs. 0.08-0.12). Other than radiation changes, diameter measurement differences and part-solid nodules misclassification as a ground-glass nodule caused most Lung-RADS miscategorization. Conclusions: When assessing asymptomatic patients for pulmonary nodules, finding a negative screen using ULD CT with denoising makes it highly unlikely for a patient to have a pulmonary nodule that requires aggressive investigation. Future studies of this technique should include larger cohorts and be considered for lung cancer screening as radiation exposure is radically reduced.
MeSH term(s)	Aged ; Aged, 80 and over ; Cohort Studies ; Female ; Humans ; Lung Neoplasms/diagnostic imaging ; Lung Neoplasms/pathology ; Male ; Middle Aged ; Observer Variation ; Prospective Studies ; Radiation Dosage ; Radiation Exposure ; Tomography, X-Ray Computed/methods
Language	English
Publishing date	2021-09-02
Publishing country	Israel
Document type	Comparative Study ; Journal Article
ZDB-ID	2008291-5
ISSN	1565-1088 ; 0021-2180
ISSN	1565-1088 ; 0021-2180
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Zs.A 5470: Show issues

Location:
Je nach Verfügbarkeit (siehe Angabe bei Bestand)
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Jg. 1995 - 2021: Lesesall (2.OG)
ab Jg. 2022: Lesesaal (EG)

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Article: Incidental Detection of COVID-2019 on Magnetic Resonance Imaging.

Nissan, Noam / Kerpel, Ariel / Zohar, Daniela Noa / Orion, David / Amit, Sharon / Marom, Edith Michelle / Konen, Eli

The Israel Medical Association journal : IMAJ

2020 Volume 22, Issue 8, Page(s) 521–522

MeSH term(s)	Adult ; COVID-19/diagnosis ; COVID-19/diagnostic imaging ; COVID-19/pathology ; COVID-19 Testing/methods ; Female ; Humans ; Incidental Findings ; Lung/diagnostic imaging ; Lung/pathology ; Magnetic Resonance Imaging/methods ; Polymerase Chain Reaction/methods ; Young Adult
Language	English
Publishing date	2020-11-25
Publishing country	Israel
Document type	Case Reports ; Journal Article
ZDB-ID	2008291-5
ISSN	1565-1088 ; 0021-2180
ISSN	1565-1088 ; 0021-2180
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Zs.A 5470: Show issues

Location:
Je nach Verfügbarkeit (siehe Angabe bei Bestand)
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Jg. 1995 - 2021: Lesesall (2.OG)
ab Jg. 2022: Lesesaal (EG)

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Article: Imaging Findings in Four COVID-19 Patients

Kerpel, Ariel / Nissan, Noam / Klug, Maximiliano / Amit, Sharon / Konen, Eli / Marom, Edith M

Isr Med Assoc J

Keywords	covid19
Publisher	WHO
Document type	Article
Note	WHO #Covidence: #32286021
Database	COVID19

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Article ; Online: Diagnostic and Prognostic Value of Chest Radiographs for COVID-19 at Presentation.

Kerpel, Ariel / Apter, Sara / Nissan, Noam / Houri-Levi, Esther / Klug, Maximiliano / Amit, Sharon / Konen, Eli / Marom, Edith M

The western journal of emergency medicine

2020 Volume 21, Issue 5, Page(s) 1067–1075

Abstract: Introduction: Pulmonary opacities in COVID-19 increase throughout the illness and peak after ten days. The radiological literature mainly focuses on CT findings. The purpose of this study was to assess the diagnostic and prognostic value of chest ... ...

Abstract	Introduction: Pulmonary opacities in COVID-19 increase throughout the illness and peak after ten days. The radiological literature mainly focuses on CT findings. The purpose of this study was to assess the diagnostic and prognostic value of chest radiographs (CXR) for coronavirus disease 2019 (COVID-19) at presentation. Methods: We retrospectively identified consecutive reverse transcription polymerase reaction-confirmed COVID-19 patients (n = 104, 75% men) and patients (n = 75, 51% men) with repeated negative severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) tests. Two radiologists blindly and independently reviewed the CXRs, documented findings, assigned radiographic assessment of lung edema (RALE) scores, and predicted the patients' COVID-19 status. We calculated interobserver reliability. The score use for diagnosis and prognosis of COVID-19 was evaluated with the area under the receiver operating characteristic curve. Results: The overall RALE score failed to identify COVID-19 patients at presentation. However, the score was inversely correlated with a COVID-19 diagnosis within ≤2 days, and a positive correlation was found six days after symptom onset.Interobserver agreement with regard to separating normal from abnormal CXRs was moderate (k = 0.408) with low specificity (25% and 27%). Definite pleural effusion had almost perfect agreement (k = 0.833) and substantially reduced the odds of a COVID-19 diagnosis. Disease distribution and experts' opinion on COVID-19 status had only fair interobserver agreement. The RALE score interobserver reliability was moderate to good (intraclass correlation coefficient = 0.745). A high RALE score predicted a poor outcome (intensive care unit hospitalization, intubation, or death) in COVID-19 patients; a score of ≥5 substantially increased the odds of having a poor outcome. Conclusion: Chest radiography was found not to be a valid diagnostic tool for COVID-19, as normal or near-normal CXRs are more likely early in the disease course. Pleural effusions at presentation suggest a diagnosis other than COVID-19. More extensive lung opacities at presentation are associated with poor outcome in COVID-19 patients. Thus, patients with more than minimal opacities should be monitored closely for clinical deterioration. This clinical application of CXR is its greatest strength in COVID-19 as it impacts patient care.
MeSH term(s)	Adult ; Aged ; Aged, 80 and over ; Area Under Curve ; Betacoronavirus/isolation & purification ; COVID-19 ; COVID-19 Testing ; Case-Control Studies ; Clinical Decision Rules ; Clinical Laboratory Techniques/methods ; Coronavirus Infections/diagnosis ; Coronavirus Infections/diagnostic imaging ; Female ; Humans ; Lung/diagnostic imaging ; Male ; Middle Aged ; Observer Variation ; Pandemics ; Pneumonia, Viral/diagnostic imaging ; Prognosis ; ROC Curve ; Radiography, Thoracic ; Reproducibility of Results ; Retrospective Studies ; SARS-CoV-2 ; Single-Blind Method
Keywords	covid19
Language	English
Publishing date	2020-08-17
Publishing country	United States
Document type	Journal Article
ZDB-ID	2375700-0
ISSN	1936-9018 ; 1936-9018
ISSN (online)	1936-9018
ISSN	1936-9018
DOI	10.5811/westjem.2020.7.48842
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article ; Online: Gastric Banding: Complications Identified by CT.

Kerpel, Ariel / Klang, Eyal / Konen, Eli / Marom, Edith Michelle / Amitai, Marianne Michal

Obesity surgery

2018 Volume 29, Issue 2, Page(s) 499–505

Abstract: Purpose: Laparoscopic adjustable gastric banding (LAGB) used to be a common procedure at the turn of the century and is still frequently encountered on CT scans in common clinical practice. Our aim is to present the frequency and spectrum of ... ...

Abstract	Purpose: Laparoscopic adjustable gastric banding (LAGB) used to be a common procedure at the turn of the century and is still frequently encountered on CT scans in common clinical practice. Our aim is to present the frequency and spectrum of complication associated with LAGB, as observed in CT. Materials and methods: After approval of our institutional review board, a retrospective search for LAGB in CT interpretations using the term "band" between December 2011 and April 2017 was conducted. CT scans were reviewed to identify complications. The findings were divided into two groups: symptomatic, in which the complications caused acute symptoms for which CT scans were conducted, and incidental, in which complications were incidentally identified. The frequency of complications was calculated. Results: We identified 160 patients who underwent LAGB and performed a CT scan. Complications were identified in 69/160 (43.1%) patients, with a total of 83 findings: 47/160 (29.4%) esophageal dilatation, 13/160 (8.2%) pulmonary complications, 6/160 (3.8%) abdominal abscesses, 5/160 (3.1%) small bowel obstructions, 4/160 (2.5%) intragastric band erosions, 4/160 (2.5%) tube disconnections, 3/160 (1.9%) port site and tube course infections, and 1/160 (0.6%) small pouch bezoars. When compared with patients' referral notes, 38/83 (45.8%) of the findings were associated with acute symptoms, whereas 45/83 (54.2%) of the findings were incidental. Eighteen percent of the incidental complications were clinically important. Conclusion: Complications were found in 43% of CT scans of patients who underwent LAGB; less than half of the findings were symptomatic. Some of the incidentally identified complications had substantial clinical importance.
MeSH term(s)	Gastroplasty/adverse effects ; Humans ; Postoperative Complications/diagnostic imaging ; Radiography, Abdominal ; Retrospective Studies ; Tomography, X-Ray Computed
Language	English
Publishing date	2018-10-02
Publishing country	United States
Document type	Journal Article
ZDB-ID	1070827-3
ISSN	1708-0428 ; 0960-8923
ISSN (online)	1708-0428
ISSN	0960-8923
DOI	10.1007/s11695-018-3534-z
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Zs.A 3381: Show issues

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Article: Incidental Detection of COVID-2019 on Magnetic Resonance Imaging

Nissan, Noam / Kerpel, Ariel / Zohar, Daniela Noa / Orion, David / Amit, Sharon / Marom, Edith Michelle / Konen, Eli

The Israel Medical Association journal : IMAJ

Keywords	covid19
Publisher	WHO
Document type	Article
Note	WHO #Covidence: #723021
Database	COVID19

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Article ; Online: Diagnostic and Prognostic Value of Chest Radiographs for COVID-19 at Presentation

Ariel Kerpel / Sara Apter / Noam Nissan / Esther Houri-Levi / Maximiliano Klug / Sharon Amit / Eli Konen / Edith M. Marom

Western Journal of Emergency Medicine, Vol 21, Iss

2020 Volume 5

Abstract	Introduction: Pulmonary opacities in COVID-19 increase throughout the illness and peak after ten days. The radiological literature mainly focuses on CT findings. The purpose of this study was to assess the diagnostic and prognostic value of chest radiographs (CXR) for coronavirus disease 2019 (COVID-19) at presentation. Methods: We retrospectively identified consecutive reverse transcription polymerase reaction-confirmed COVID-19 patients (n = 104, 75% men) and patients (n = 75, 51% men) with repeated negative severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) tests. Two radiologists blindly and independently reviewed the CXRs, documented findings, assigned radiographic assessment of lung edema (RALE) scores, and predicted the patients’ COVID-19 status. We calculated interobserver reliability. The score use for diagnosis and prognosis of COVID-19 was evaluated with the area under the receiver operating characteristic curve. Results: The overall RALE score failed to identify COVID-19 patients at presentation. However, the score was inversely correlated with a COVID-19 diagnosis within ≤2 days, and a positive correlation was found six days after symptom onset.Interobserver agreement with regard to separating normal from abnormal CXRs was moderate (k = 0.408) with low specificity (25% and 27%). Definite pleural effusion had almost perfect agreement (k = 0.833) and substantially reduced the odds of a COVID-19 diagnosis. Disease distribution and experts’ opinion on COVID-19 status had only fair interobserver agreement. The RALE score interobserver reliability was moderate to good (intraclass correlation coefficient = 0.745). A high RALE score predicted a poor outcome (intensive care unit hospitalization, intubation, or death) in COVID-19 patients; a score of ≥5 substantially increased the odds of having a poor outcome. Conclusion: Chest radiography was found not to be a valid diagnostic tool for COVID-19, as normal or near-normal CXRs are more likely early in the disease course. Pleural effusions at presentation suggest a diagnosis other than COVID-19. More extensive lung opacities at presentation are associated with poor outcome in COVID-19 patients. Thus, patients with more than minimal opacities should be monitored closely for clinical deterioration. This clinical application of CXR is its greatest strength in COVID-19 as it impacts patient care.
Keywords	Medicine ; R ; Medical emergencies. Critical care. Intensive care. First aid ; RC86-88.9 ; covid19
Subject code	610
Language	English
Publishing date	2020-08-01T00:00:00Z
Publisher	eScholarship Publishing, University of California
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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